Skip to comments.In Texas, a surprising Perry plan for Medicaid reform (Surprise! Surprise! Surprise!)
Posted on 11/19/2011 12:17:32 PM PST by Cincinatus' Wife
Its a perennial complaint from Texas Gov. Rick Perry: The federal government places far too many restrictions on how states can run Medicaid, the entitlement program that provides health care to low-income Americans. We know for a fact that, given that freedom, the states can do a better job of delivering health care, Perry said in a Republican debate last month. Hes endorsed turning the entitlement program into a block grant and flirted with having Texas drop out of it altogether.
But back in Texas, Perry is actually pursuing a highly technocratic and pragmatic attempt at Medicaid reform that doesnt much resemble the policy hes floated in his presidential run. He is currently negotiating a waiver with the Obama administration that would net the state increased Medicaid funding if providers could hit certain performance metrics agreed to by the federal government. Its an approach that has pleased just about everyone involved, from Medicaid advocates to major hospitals.
As an advocate, if this is done reasonably well, it could be requiring more from hospitals for what theyre doing, says Anne Dunkelberg of the Center for Public Policy Priorities. It wouldnt just be a cash cow. Hospitals would have to deliver care to the uninsured and have to participate in some payment and delivery reforms.
......But from hospitals to Medicaid advocates, theres a surprisingly high level of agreement on what the waiver would do: bring in more Medicaid dollars to Texas. As for Perry, it shows a political side rarely seen in his presidential debate performances: pragmatic and technocratic, a leader who can craft a deal that brings together just about every disparate health-care interest in the Lone Star State.
(Excerpt) Read more at washingtonpost.com ...
Richard Fisher, president of the Dallas Federal Reserve Board, told me that if you look at the number of jobs created since the recession technically ended in June 2009, Texas has accounted for 48 percent of net new jobs created in the U.S.
Fisher also disparages claims that the jobs are all low-paying jobs at McDonalds or Walmart, paying the minimum wage, or that they were primarily caused by the oil and natural gas boom. According to Tom Pauken of the Texas Work Force Commission, the annual median wage in Texas in 2010 for all occupations was $31,500 a year, only 7 percent below the national average. That difference is easily explained by the fact that Texas has a younger workforce than most states and a higher percentage of workers in lower-pay agriculture jobs near the border with Mexico. [ CW: Cost of living in Texas is lower than many other states; Texas has no state income tax; Texas is a right to work state.]
As for where the job growth has been, three sectors of the economy have grown faster than the energy sector, which alone added 40,500 net new jobs in 2010. Last year, Texas added 57,900 new jobs in trade, transportation, and utilities; a total of 53,400 jobs in professional and business services; and 44,900 net new jobs in the hospitality industry.
For each of the past seven years, CEOs polled by Chief Executive magazine have rated Texas first in the nation for economic development climate and job growth. What is the secret of Texass success? Rick Perry isnt shy about his answer. Its all about four points, he told me. First, dont spend all the money. Keep the taxes low and under control. Have regulations that are fair and predictable so business owners know what to expect from one quarter to the next. And reform the legal system so that frivolous lawsuits dont paralyze employers who are trying to create real wealth.
If there is on issue which Perry has made a personal crusade, it is lawsuit reform. Working with the legislature, he has helped pass curbs on frivolous lawsuits, implemented a first-in-the-nation system under which loser pays all court costs in many lawsuits, and reformed medical malpractice law.
Dick Weekley, the co-founder of Texans for Lawsuit Reform, says Perry showed genuine political courage in resisting calls for watered-down reforms that wouldnt have addressed the core problem. He recalls that in 2002 Perry vetoed a bill strongly supported by doctors that would have required them to prompt payment from health maintenance organizations. In the eyes of the tort reform advocates, the bill was a Trojan Horse compromise negotiated between doctors and trial lawyers. There was a huge response from physicians [against the veto], Kim Ross, the former top lobbyist for the Texas Medical Association, said. TMA went so far as to endorse Tony Sanchez, Perrys millionaire Democratic opponent in the 2002 election. Perry sent a signal that he wanted real reform and would stand his ground, Weekley told me. Soon the medical lobbyists playing footsie with the trial lawyers were gone and the obstacles to real reform started falling. ..
AND now the TMA is endorsing Gov. Rick Perry. They understand now what he was doing would HELP them.
...."The Texas Medical Associations political action committee recently endorsed him for president, and its members are helping him raise money and make connections with medical groups in other states.".... source
"With the signature of Gov. Rick Perry today, Texas has joined three other states stating their intention to enter into a health care compact.
The compact, which would challenge the authority of the federal government to dictate the terms of the federally and state funded Medicaid program, was part of a wide-ranging health care reform bill, Senate Bill 7, passed by the Texas Legislature in its recently concluded special session.
Georgia, Oklahoma and Missouri have already signed onto the compacts movement, with Missouri Gov. Jay Nixon signing a bill into law on Thursday.
The law establishes Texas, along with the other three states, as pioneers in an uncharted use of Article 1, Section 10 of the Constitution which allows states to enter into agreements that, with the approval of Congress, cannot be abridged by the federal government. There are more than 200 state compacts currently in effect, nearly all of them related to commerce. ..
MEANWHILE MITT ROMNEY is pushing these health care exchanges
July 16, 2011: Romney Adviser Backs Obama Health Exchanges
SALT LAKE CITY Former Utah Gov. Mike Leavitt, a top supporter and adviser of Republican White House hopeful Mitt Romney, strenuously backed the core piece of President Barack Obamas health-care law and urged the states to move forward together in adopting health insurance exchanges.
Speaking to a bipartisan group of governors at the National Governors Association, the former Republican governor who served as secretary of health and human services in the Bush administration, called the exchanges where individuals and small businesses can purchase health plans a very practical solution to a problem that needs to be solved. He warned governors who are reluctant to move forward with their state-level exchanges that their intransigence will only empower federal regulators.
Perhaps, but the states shouldn't be involved, anyway. It's always going to be more efficient and better if it's doctor/patient and no one else.
Let’s get it away from the Feds and keep moving it back to the people.
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“Hospitals would have to deliver care to the uninsured and have to participate in some payment and delivery reforms.”
If my husband paid the hospital to let him work there, would that help?
After being Gov for 11 years, I am surprised that he is bringing this up now.....no I am not. He sure is brining up a lot of good ideas now that he is running for President. Had he been bringing these things up while governor and getting them implemented, he might have a fighting chance at being the nominee. Perhaps if he takes these Ideas and works on them the next four years, he can come back for 2016 and have a better chance. He will only be 64 going on 65. He has plenty of time to run again. Too bad he didn’t think about running around 2009 and implementing some of these ideas even then would have helped.
All I know is this: I’ve been without healthcare insurance since 2009. I pay a flat rate to my doctor for visits and out of pocket for meds. In that time, I’ve spent less than I would have with premiums and co-pays.
You know, you never have anything good to say about Gov. Perry and work so hard to leave a bad impression. He has done a lot for Texas— he’s battling the Feds on many issues— the state economy is booming despite Obama — have you bothered to take note? (and I have linked and quoted and given information to you countless times to the point I’m insulted for doing it).
Who is your candidate that you are trying so hard to get elected by repeatedly slamming Gov. Rick Perry, a strong fiscal and social conservative?
You’re right of course. He’s only been elected Governor of Texas 3 times...more than any other Texan...because in all that vast state there simply isn’t anyone else to do the job.
No argument there, but having a government entity involved, federal, state, or otherwise.....it’s problematic. Implemetation of a government plan invites corruption and poor care.
Nov 19, 2011: Since tickets have sold out, please join the Thanksgiving Family Forum streaming live from 3:30-6:00 PM CST: Here
“I pay a flat rate to my doctor for visits”
We have health care coverage, but I still payed cash to the Doc I was seeing, thus paying 1/3 the normal charge.
The Doc appreciated the cash and savings in bookwork.
I like doing things that way.
The Current FReepathon Pays For The Current Quarters Expenses?
How do you square your comment:
“Lets get it away from the Feds and keep moving it back to the people.”
with the stated purpose of Perry’s proposal:
“theres a surprisingly high level of agreement on what the waiver would do: bring in more Medicaid dollars to Texas.”
Not only is government best when it governs least, it governs best when its closest to the people.
Call this, roundabout federalism. Rick Perry gets it.
That is not exactly getting the FedMob out of it. That is still playing by their rules.
lol. I was giving the guy advice. Well it is up to him. I am for Cain, Bachmann or Santorum. Any of these three are incredibly more conservative than moderately conservative Perry, Romney, or Newt. This is our best opportunity to really get a conservative into the White House. Cain is 100 percent conservative, Bachmann is 100 percent conservative and Santorum is 100 percent conservative. Romney is about 30 percent conservative. Newt is about 40 percent conservative and Perry is about 45 percent conservative. Perry supports illegal aliens which is why I will NEVER support him even if he is the nominee. I can’t. I cannot put my opportunity to go to Heaven in place of politics. It just won’t happen. Perry supports people who break the law. That is unacceptable.
LOL Cain is a faux conservative, a political neophyte which makes him a 100% empty suit.
This is a note on the Tyler Planned Parenthood door. This due to Perry and the Legislature defunding it. This is called walking the walk. Cain can agree abortion should not be part of the political discussion. He can call abortion a social decision but Gov. Perry puts his money where his mouth is. This is just another reason why he should be President.
By the way this is the 13th Texas planned parenthood to do this.
Given that Herman Cain has never served in an elective office how can you say that he’s 100 percent conservative? I’d argue that his Opportunity Zones are, at best, moderate.
Oh, btw, Rick Perry does not support illegal aliens.
Just look at this case, it's a waiver they've been negotiating with the Obama regime for some time. He can't just wave a magic wand and get the feds to do his bidding from TX.
If Perry had been thinking about running in 2012 before a few months ago, he'd have been in better shape and not made the debate mistakes he's made making him the leading non-Romney. It's unfortunate we have so many unprepared candidates trying to fill that spot and it seems we're down to Newt.
And I will add that the American people will not accept a George Bush clone - a clone who makes GWB look like a winner of an Oxford Union debate against Christopher Hitchens and Martin Amis. It depresses me that such an inarticulate cluck could ever attain the White House.
And I just don’t think Americans are going to go for it.
The Brokeback Perry series of photos have returned, I see. Yuck!
I'm from/in Texas and though I'm not es tactic about him, I see him as the lesser of all evils currently running that can beat obummer.
After 3 months of explanations about the TX tuition program it's impossible to believe that you don't understand it, or why it was done. The only alternative explanation to you being ignorant by choice is you think lying helps who ever it is you support. I'm guessing your a Cain supporter. We haven't seen this type of crap from Newt, Bachmann, or Santorum supporters.
It’s a step in the right direction.
Be a little careful about throwing the dumb word around, Naps.
Seeing as who your candidate is.
the Dallas Observer just blamed the rise in HIV among young men in the Dallas area on Rick Perry.
Because they say he got rid of Planned Parenthood.
Well, not completely yet, but he’s trying.
Miss marmelstein, who do you think you’re doing any good for with a nasty comment like that?
Certainly not your candidate and certainly not yourself.
>>>>>... dumb Perry.
In the last few weeks its obvious Cain is in over his head. His public statements have shown Cain is a policy dumbell of the first order.
Yes, even Mark Davis (local area conservative talk show host who subs for Rush sometimes) said Cain has proven that he’s not up to the job.
He was among the people (including me) who defended Cain against the so-called bimbo eruption, but he’s seen the light.
Go take a nap, Rickster is running now and I am pulling for him
Don’t use so such language w her
I, too, am self-pay, and I too spend far less.
But one major surgery or serious accident and you’ll find yourself headed for Chapter 11... as we did. It wiped us out completely.
I wish it were possible to buy insurance for major medical only. I’d rather pay in cash for routine care. But if you are self-employed, have any kind of pre-existing condition and/or are over forty, you can forget it. No insurer will touch you.
See you at the county emergency ward. Hope your Spanish hasn’t gotten rusty.
And you have probably received better care. Most doctors will negotiate a fee for office visits - within reason - if paid in cash or by check. Saves them and their staff a whole lot of time and, therefore, money if they don’t have to deal with the insurance hassle.
You can support a loser go ahead. Don’t come crawling to me when he places last in Iowa. Well MAYBE 6th. HE will DEFINITELY not be in the top 4 for sure.
That is so true. 1000%.
Thank God for Jesus the Christ.
Without that, the number of dead would be numberless.
Too bad he didnt think about running around 2009 and implementing some of these ideas even then would have helped.
The commies spent 20 years grooming (and disappearing) zero, and instructed the LSM to 100% shut up and take it.
This is why Perry had to lay low, let the ‘can’t debate’ meme take hold, to keep the bullets off him while he got out and talked to the states.
He will either pull it off or he won’t. At least keep an ope n mind as to his targets, and how those targets became his targets.
Excellent post, CW! I like what Gov. Perry is doing. Get the Fed out of our lives as much as possible. Return power to the states and the people.
Opportunity zones? Are those like the special economic zones of China and North Korea... where the rules prohibiting economic development are not in effect?
And if they are, how could *ANYONE* say that doing something like this would be remotely conservative?
America is the land of opportunity... not just certain special areas of it, for G-d’s sake!!!
So those ‘special rules’ that the opportunity zones would get should be the standard law of the land.